Open Access Review

Crew resource management in the ICU: the need for culture change

Marck HTM Haerkens1*, Donald H Jenkins2 and Johannes G van der Hoeven3

Author Affiliations

1 Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, Braspenninglaan 2, 5337, NK ‘s-Hertogenbosch, The Netherlands

2 Division of Trauma and Critical Care, Mayo Clinic, Rochester, MN, USA

3 Department of Intensive Care Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

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Annals of Intensive Care 2012, 2:39  doi:10.1186/2110-5820-2-39

Published: 22 August 2012

Abstract

Intensive care frequently results in unintentional harm to patients and statistics don’t seem to improve. The ICU environment is especially unforgiving for mistakes due to the multidisciplinary, time-critical nature of care and vulnerability of the patients. Human factors account for the majority of adverse events and a sound safety climate is therefore essential. This article reviews the existing literature on aviation-derived training called Crew Resource Management (CRM) and discusses its application in critical care medicine. CRM focuses on teamwork, threat and error management and blame free discussion of human mistakes. Though evidence is still scarce, the authors consider CRM to be a promising tool for culture change in the ICU setting, if supported by leadership and well-designed follow-up.

Keywords:
Intensive care; Human factors; Safety climate; Crew resource management